Twists and Turns
by SynBabe
Summary: Hank heads out for a game of tennis with Tucker, Libby, and a friend, and winds up with a medical mystery on his hands. Oneshot, complete.


**Author's Note: This is my first Royal Pains fanfiction. I appreciate any and all feedback!**

After a long day at work, no matter how beautiful the scenery, all Hank really wanted to do was sit down with a good book and maybe a shot or two of something a little stronger than tea. So it was only natural that as soon as he had divested himself of his obnoxiously embroidered HankMed bag and relaxed into his favorite thousand dollar chair, his cell phone vibrated.

"You have got to be kidding me," he groaned, but reached over and picked up his shuddering phone. A tiny envelope was fluttering on his screen, alerting him to a text message. Wearily, he opened it, but instead of the frantic "Come now to this address!" he was expecting, the message was from Tucker Bryant.

"Got a fourth for doubles. See you in fifteen."

Despite himself, Hank smiled. Ever since he had dropped a mention of his desire to learn tennis, Tucker had taken it upon himself to find the perfect quartet for tennis doubles. Assuming the first three members to be Tucker, Hank, and Libby, the group had tried four combinations already, but they had been, to put it gently, flops. Looks like the heir to the blender fortune wasn't giving up yet, though.

Hank stretched, feeling the tension in his neck and down his back. Maybe a tennis game or two would be exactly what he needed to unwind. He jumped out of his chair and five minutes later was in the car, top down, speeding towards the Bryant mansion.

As Hank pulled up to the exotic wood and glass walled mansion, a slender figure with a shock of black hair stepped out to meet him. Tucker Bryant was already wearing a pair of pristine white shorts and a loose shirt and twirling a tennis racquet in his right hand, a grin on his face.

"Hey old man, ready to go down?" he called, deep voice easily traveling the distance between the two men.

"You know it!" Hank called back, slamming the car door behind him. He jogged easily up the steps and clapped Tucker on the shoulder by way of a greeting. He also took the opportunity to cast a medical eye on the younger boy, looking for any suspicious cuts or bruises. Although Hank was no longer technically the Bryants's doctor, he had decided that part of his services as "friend" would be to utilize his medical knowledge to keep Tucker in good health. Satisfied, he returned his attention to the more immediate matter.

"So who'd you get to join us today?" Hank asked as they passed through the house's impressive lobby. "Anybody I might know?"

Tucker shrugged and shook his head.

"I doubt it," he responded, pushing the back door open. The duo headed out onto the grounds, the tennis court with two tiny figures just visible in the distance. "It's some girl Libby knows from boarding school or whatever. Or camp. All I know is they saw each other in a coffee shop two days ago, squealed in a register that can't be safe for humans, and now she's playing with us." He shot Hank an amused, tolerant look as if to say "Girls. Whaddaya do?"

Hank grinned back. "Well, it can't be worse than that guy last time. John, right?"

Tucker grimaced. "Yeah, maybe this girl can actually hit the little green ball."

After a few moments of walking in silence, they arrived at the tennis court, which was full of soprano voices. The sun was setting in the west, creating a breathtaking visual panorama over the tops of the carefully cultivated trees. Shadows were lengthening, but the buzz of the tennis lights were beginning to lighten the court already. The gate swung open with a creak and both girls swung around to see their partners.

"Hey Hank!" Libby called, waving excitedly. Her blond hair was pulled up into a tight ponytail, complemented by a cream colored tennis dress. Her appearance was that of a serious tennis player, but Hank was well aware that it was just that- appearance. Libby was a competent tennis player, but the third time she lost her grip and the tennis racquet went sailing over the net, Hank had begun to suspect that she enjoyed the idea of the game more than the game itself. Of course, that conclusion came after Libby insisted on a full workup to rule out nervous damage as the root of her…ah…_enthusiastic _swing.

"Libby," Hank called back, raising a hand in greeting. Libby jogged over to grab Tucker's hand and started to pull him onto the court.

"C'mon, come meet my friend Rebekah," she chirped. Hank raised an eyebrow at Tucker.

"I thought you had met this girl already," Hank asked quietly. Tucker shook his head.

"Nah, man, Libby told me about it afterwards. I've got no idea who your new partner is."

"But the squealing? Sounded pretty first-hand to me."

The young man quirked his mouth in a smile over his shoulder. "It's how Libby says hi to all her girl friends. Plus, it makes for a better story."

Hank rolled his eyes, but saved his marriage quip for later.

"Alright, so, Hank, Tucker," Libby said, taking the girl's arm, "Meet my friend Rebekah von Kessler. We've known each other for ages. "

Rebekah von Kessler herself smiled at the two men Libby had dragged onto the court.

"I don't know if I would call two summers ages, Libby" she corrected swiftly, but teasingly. Her words had a lilt to them, but whether from traveling or living abroad, it was impossible to say. She was a little taller than Libby and probably thirty pounds heavier, something of an anomaly in the Hamptons. Her peach colored outfit blended with skin the color of the inside of an almond and thick brown hair with red highlights was coiled into a tight bun on the nape of her neck. A silver chain glinted in the deep V-neck of her sleeveless shirt.

She stuck her hand out to Tucker, then Hank.

"Like Libby already said, my name is Rebekah. I'm going to guess that you are Hank," she said, smiling, "Since I know Libby is dating Tucker, and I really doubt that she would pick someone, ah, older. So you're my partner?"

Hank nodded. "Yeah, you would be right. So, shall we play?"

"You know it!" Tucker said enthusiastically, turning with Libby to jog over to the opposite side of the court. "Hank and Rebekah, there are a couple of racquets over next to the fence. Pick one you like."

Hank turned to see an impressive selection of racquets piled neatly a few feet away. He motioned for Rebekah to take first pick, but she shook her head and grinned.

"Thanks, but I brought my own. It's right over there, though, so I can help you pick one out if you want."

She indicated a black case next to the pile of racquets.

Hank shrugged. "Ah, sure. Thanks. So I guess you've got some tennis experience then?"

Rebekah tilted her head a little to the left, considering the selection and question equally. She reached for a medium sized one and handed it to Hank.

"Try this. It looks like it's about the right size. And, yes, I've played a few times. You?"

Hank hefted the racquet, impressed by Rebekah's selection. "I played a lot more when I was younger. I'm a little rusty now, but I'm getting it back."

The young woman raised an immaculate eyebrow. "I see." She turned and bent down to unzip her own racquet case, exposing a length of barely tanned lower leg that drew Hank's attention. Not, however, the leg itself, but rather the impressively large patch of gauze that was covering it.

"Sorry, I don't mean to pry, but is everything OK with your leg? That's a pretty large bandage." Almost involuntarily, Hank felt himself slip into doctor mode.

Rebekah stood and turned to face Hank in one smooth motion.

"That's right, Libby said you were a doctor. Well, it's really nothing to worry about. I just took a tumble down our stairs a few days ago and sliced my calf pretty bad. It needed a few stitches, but it's fine. Thanks." Her tone made it clear that the concern was unwanted and unwarranted. But still, Hank couldn't quite let it go. He had learned to trust that niggling voice in the back of his head, and right now it wouldn't shut up.

"You fell on stairs and needed stitches," he repeated, curiosity tingeing his voice. His brown eyes were questioning.

"They're marble stairs." Rebekah responded shortly, and began walking back to the court.

Hank took a deep breath and let it out in a huff.

"Marble stairs. Of course. Anybody who's anybody got out of wood _ages _ago," he said under his breath in an uncanny Hampton-ite impersonation as he walked over to join Rebekah, Tucker and Libby.

"Took you long enough," Tucker said, laughing. "Afraid you're gonna lose?"

"Not even!" Rebekah shot back before Hank could even open his mouth.

"We'll see about that!" rejoined Libby, tossing the ball up in the air and serving. And the game was on.

The shadows lengthened outside the fence, but the tennis court stayed blindingly bright as the steady _thwap_ of balls continued, interspersed with shouting and good natured jeering from both sides. Hank realized quickly that Rebekah's "a few times" was something of an understatement. The girl was _good,_ moving all over the court and hitting the ball with geometric precision. Frankly, Hank was surprised that she was that agile at all, between the extra weight and bandage, let alone that skilled. Tucker was dashing around, trying to keep up with Rebekah's returns, and Libby apparently kept forgetting that she was supposed to be playing against Hank and Rebekah and continually called out encouragement to Rebekah, at the expense of her own returns.

It was three games later, and the pre-determined last game, before Hank even looked at his watch. He took that as a good sign, and made a mental note to talk to Tucker about considering Rebekah as a permanent addition to their group when it happened. One of Rebekah's laces had come untied bit by bit during the game. Tucker served the ball and it flew straight and true to only about a yard to the left of Rebekah, and she lunged for it, but caught her foot on the errant shoelace. She fell hard, twisting as she fell so that she skidded on the gauze bandage, pulling it up and exposing it to further damage.

She lay where she fell, curled and instinctively clutching her wound. Rebekah didn't make a sound, but her face blanched white and she bit her lip hard.

Hank dropped his racquet and hurried over to Rebekah. He didn't expect anything serious from just a fall, but it was best to make sure. Libby also raced over to that side of the court and dropped next to Rebekah. Tucker remained on his side, leaning on the net with a worried expression on his face.

"Rebekah, look at me," Hank said gently, but firmly. "I'm going to take a look at your leg, just to make sure it's alright. OK?"

Rebekah glanced up at Hank, nodded briefly and returned to her fixed stare in the distance.

Hank gently rotated Rebekah's leg so he could have a clear view of the bandage, or what was left of it. He took a deep breath as he surveyed the damage. It looked as though a few of the stitches had ripped out and the gash had reopened. It was bleeding profusely. _But, _thought Hank to himself, as he examined the problem, _She's a healthy girl, a few swabs of alcohol, a few stitches, and an hour or so off it, and she'll be fine._

"She's going to be OK, right?" Libby said anxiously, clutching Rebekah's hand. "Oh God, say it's not gangrene? You won't have to amputate, will you?" Her voice got higher and faster as she spoke. Hank reached over to pat Libby encouragingly on the shoulder.

"Stay with me, Libby, she'll be fine. Unless you break her hand off," he said, motioning to Libby's tight grip. She nodded, trembling a little and slacked off. Hank looked up at Tucker.

"OK, Goose, go grab my bag. I should have everything I need in it." Tucker jogged over to the infamous HankMed bag, while Hank returned his attention to Rebekah.

"Relax, this isn't serious," he said encouragingly. "I'm sure that stings pretty bad, but it should clot up in no time. Thanks, Tucker," he said, as the medical bag landed with a thump beside him. He started rummaging in its depths and pulled out a handful of alcohol pads and a pair of rubber gloves. He pulled the gloves on with a snap and ripped open the pads. He paused for a second.

"This is not going to be pleasant," he warned. Rebekah nodded wordlessly, and Hank pressed the soaked pads to her crimson skin. Rebekah hissed involuntarily and clutched Libby's hand, but Hank was nodding approvingly.

"Good girl," he said, gently wiping her skin. He tossed the scarlet pads into a small plastic bag and pulled out a stack of gauze pads from the duffel bag.

"I'm going to press these against your leg until the bleeding slows, then I'll tape you up good as new," Hank said conversationally, as he applied pressure to Rebekah's leg. The gauze was immediately soaked through, and Hank frowned slightly. He tossed the soaked gauze away and replaced it with a new pad.

"You're a bleeder, huh?" he said with a little chuckle. Rebekah relaxed at the sound, and nodded, smiling sheepishly. Libby smiled down at her friend and laughed too.

"You have no idea," Libby said. "She used to get these terrible nosebleeds at camp. That's how we met, actually. I was in the infirmary because I was showing the beginning signs of Rocky Mountain Spotted Fever-"

"In Vermont, I might add," interjected Rebekah quietly, winking at Hank. It appeared that Libby's cyberchondria had history. He smiled back.

"Well, it could happen!" Libby said defensively, ponytail swaying as she turned to glare at Tucker and Hank. "Anyway, so I was sitting there, and this girl comes in, gushing blood from her nose, dress _totally_ ruined-" Hank reached over to switch out the second soaked pad with a new one. "And I screamed, and she screamed and then once everything settled down, we were best friends forever. Right, Bekah?" Libby's pale slender fingers, squeezed Rebekah's rounder ones.

"Uh, Hank?" Tucker's voice broke the moment, concern evident on his face. "I don't think the gauze is helping. Like, at all."

Hank looked up sharply. "What do you mean, Tucker?"

Tucker swung himself over the net and crouched next to Rebekah, across from Hank. He pointed, not at Rebekah's leg, but underneath it.

"I thought it was a shadow," he said quickly, "Because of all the lights, you know, but it's gotten bigger. I think it's blood."

Without missing a beat, Hank stepped over Rebekah's prone body and crouched next to Tucker. In an instant, he realized that the young man was right. Because of his vantage point, Hank had noticed the dark splotch, but assumed, like Tucker, that it was a shadow. Now that he was blocking the blazing light, he could see that it was, in fact, a spreading pool of blood from her calf. It had just begun to soak into Rebekah's skirt, creating a dull red border across the bottom, at odds with the crisp pink linen. Immediately, Hank's mind clicked into high gear.

"OK, something is very wrong here. This isn't a serious enough wound to be causing this much bleeding. Rebekah, is there anything I need to know that you're not telling me? Any medical conditions, drugs, anything. I need you to be honest!"

Rebekah shook her head weakly, blanching white against the green of the tennis court. Her neat bun had begun to unravel, creating a dark halo of frizz around her face.

"I- I don't know," she said. The lilt to her words was becoming thicker, more noticeable, and her eyelids started to droop. "I feel dizzy. And floaty." Her grip on Libby's hand loosened slightly. Libby shot a frantic glance at Hank.

"Yeah, that's the blood loss talking," he said. "Libby, put a new piece of gauze on and press tightly. I'm going to see what I can use for a tourniquet." Hank turned towards his bag, hoping to find something, anything, he could use to tie off the blood supply, but he had barely started looking when he heard Libby shriek.

"Oh, God, what's wrong, she's having a seizure or something!"

Hank spun back around and saw that Rebekah's eyes were almost closed, just a slit of white visible, and she was, indeed, shaking. Her skirt was now stained almost halfway up the thigh. He grabbed a length of tubing and launched himself back over to the trio of teens.

"Libby, call an ambulance. This isn't going to stop on its own. Tucker, I need you to help me keep her still while I tie this on."

Libby was up and reaching for her cell phone before the words were out of Hank's mouth. Tucker moved in closer, waiting for Hank's instructions. Rebekah's tremors had ceased for the time being, so Hank motioned for Tucker to keep still and hold another stack of gauze pads on Rebekah's leg while he cut off blood supply. As he worked, Tucker spoke up.

"Girls can't have hemophilia, can they?" Tucker looked over at Hank, confusion and doubt written on his face. "I mean, this is familiar. But…not."

Hank shook his head as he carefully placed the tubing around Rebekah's thigh and pulled it tight. Libby finished her frantic call in the distance and hurried back to Hank and Tucker. She knelt down, lip trembling, next to her friend.

"The ambulance is on its way. Is she going to be OK?"

"Good, thank you, Libby." He increased pressure on the tourniquet, squinting against the intense tennis lights. He directed his next words at Tucker.

"The chances of that are so incredibly slim, it's not even worth-" Hank stopped suddenly, his eye caught by the silver chain, standing stark against the parchment skin at Rebekah's throat. Her tremors must have dislodged the necklace, because now the charm at the end was hanging out. A small diamond encrusted Star of David was rotating slowly, casting lacey silhouettes of shadows on the court .

"No way," Hank whispered to himself. A flash of understanding had just hit him, but he needed to confirm.

"Libby, what did you say Rebekah's last name was?"

Libby looked taken aback, but answered in a voice that was only slightly shaky. "von Kessler. Rebekah von Kessler."

"So her family's German?" Libby frowned, but Hank shook his head. "Don't argue, Libby, just answer the question!"

"Um, well, they live in this, like, eight hundred year old castle right outside Düsseldorf," Libby said hesitantly, frowning at the unexpected turn the conversation had taken. "I'm pretty sure it's her family's and German's her first language, so yeah, I'm gonna say she's German." Sarcasm crept into her voice.

"Well, a castle would explain the marble stairs," Hank, said musingly. "So she's German and Jewish?"

Libby's eyes widened and she rose up on her knees, clutching Rebekah's limp hand. Hank noticed that some of Rebekah's blood had gotten on the hem of Libby's dress as well.

"Oh my gosh, Hank, this is no time for your latent anti-Semetic tendencies to assert themselves!"

Tucker rolled his eyes and used the hand that wasn't pressing gauze onto Rebekah's leg to grab Libby's arm and gently pull her back down. Her eyes were still locked, horrified, onto Hank's face.

"Libby, breathe," Tucker said, voice sharper than usual. "Just answer the question and worry about Hank's unlikely prejudices later." He looked over at Hank and nodded.

"No, Libby, you don't understand," Hank said, relief washing over his features. "The fact that she's Jewish and German has nothing to do with prejudice. It's just, Tucker's right. Sort of."

Now it was Tucker's turn to look shocked. "What, she has hemophilia? But girls don't _get _hemophilia!"

Hank shifted his weight, and opened his mouth to speak, but at that moment, the ambulance came roaring up the drive to the tennis court and two paramedics with a stretcher jumped out and raced over to the group; one unconscious teenage girl, two kneeling, frightened teens and one well known adult. Hank stood up as the paramedics approached and started giving them all the relevant information.

"Female, 16 or 17, Ashkenazi Jew ancestry, trauma to the lower left leg, presenting with what I believe to be a severe bleeding episode of Hemophilia C. She needs a blood transfusion, stat," Hank said rapidly. One of the paramedics slowed as they hoisted Rebekah's limp body onto the stretcher.

"Wow, that's a one in a million scenario," he said, ratcheting the stretcher up to hip height and preparing to roll it out to the waiting ambulance. "How'd you catch _that, _buddy?"

Hank looked down at Rebekah's necklace and tucked it securely back into her dress.

"Just using what I had," he said absently. The paramedics started rolling the stretcher towards the ambulance.

"You got a blood type for her?" the second man asked Hank as they prepared to push their patient into the ambulance. Hank blinked, taken by surprise, as he realized that he actually didn't have that information. In the second Hank took to think, Libby hopped into the ambulance ahead of Rebekah and sat firmly on the small pull-out seat.

"It's O negative," she said firmly, crossing her arms across her chest. "And I'm coming with you. Hampton's Heritage is ranked twentieth on my list of the twenty hospitals in a fifty mile radius and I will not have you killing Rebekah through medical negligence and ignorance!"

The paramedics glanced at Hank, who put his hands up. "She's family," he said quickly. The first man shrugged, and they hoisted Rebekah up. Libby reached out as if to grab Tucker's hand. He stepped up, and squeezed Libby's hand back, then stepped away.

"We'll follow you in the Ferrari," he promised, dark, calm eyes locked on his girlfriend's worried ones. "She'll be fine." Libby nodded, and then the doors to the ambulance swung shut and it roared off into the night, sirens wailing.

Tucker and Hank stood in the sudden silence and stillness for only a second before Tucker started towards the garage. Hank looked over his shoulder to glance at the puddle of blood that Rebekah had left, glowing in the harsh light on the court like a ruby nestled in green velvet. He turned back and hurried to catch up with Tucker.

"So, you wanna explain what the hell just happened?" Tucker said as they jogged through the darkness. "You don't just fall and scrape your leg and then go to the hospital because you almost _bleed _ to death. Unless you're a hemophiliac, which, as we already determined, doesn't happen to girls!"

Hank chewed his lip for a minute, trying to formulate a response. He could understand Tucker's confusion and intense interest- as a hemophiliac, it must have seemed weirdly like staring into a polar mirror. A tiny wound that escalated into a life threatening situation.

As they rounded the corner into a huge garage, Hank answered.

"Well, you're half right."

Tucker glanced over, headed to his Ferrari. He slid into the driver's seat, and Hank swung himself into the passenger seat. The car roared to life, and they headed out into the night, towards Hampton's Heritage.

Once on the road, Tucker spoke.

"OK, so I'm half right. How am I half wrong?"

Hank nodded, and continued.

"So, you know how normal hemophilia is passed through the X gene, right? So guys only need one bad copy to express the disease and you wind up with virtually all cases of hemophilia in males. But in some populations that marry almost exclusively within that small population, you wind up with a different distribution of disease."

Tucker raised an eyebrow and glanced over. "So how does that have anything to do with Rebekah?"

"Well, based on what Libby said, Rebekah's family is part of one of those small population, Ashkenazi Jews. Jews historically from Germany, and later from Eastern Europe. Male and females alike often present with a moderate form of hemophilia," Hank added, when Tucker frowned and opened his mouth. He closed it and nodded.

"Then why didn't she say she was a hemophiliac when you asked her? I was one year old when I was diagnosed. How do you miss something like that?"

"That's the half wrong part," Hank said. "You have what's known as Hemophilia A, which is what most people have. Hemophilia C, like what I'm pretty sure Rebekah has, is way milder. It usually presents as severe post-surgical bleeding before anyone even realizes that they have hemophilia. And really severe nosebleeds," Hank added as an afterthought, suddenly recalling how Rebekah and Libby had met. "I'm not sure exactly what triggered this bleeding episode, but at least I can explain it."

"Wow," Tucker said softly. "So she got to find out that she's a hemophiliac in front of one of her best friends, the stranger her best friend's dating, and a doctor. That's lucky of her. Well, the doctor part, anyway. And Libby'll make sure the hospital treats her right."

Hank smiled and gave Tucker a firm pat on the shoulder as they pulled into the small parking lot of Hampton's Heritage.

"It's also lucky she's got a peer to talk to," he said, as they swung themselves out of the car.

Tucker shrugged. "If she even stays. Libby said she's just here for a few weeks."

Hank grinned. "Well, speaking purely selfishly, after _that_ tennis game, I think we found our fourth player. We better convince her to stay more than a few weeks!"

Tucker smiled in return, tension broken, and the two headed into the brightly lit emergency room, towards yet another new HankMed patient.


End file.
